Consensus Guidelines

In 2012, consensus regarding cervical cancer screening recommendations by age was reached for the first time among leading health organizations, including USPSTF, ACS, ASCCP, ASCP, and ACOG.*

For women ages 30 to 65, co-testing (Pap and HPV ordered together on the same accession) is the preferred/recommended form of cervical cancer screening.1-3 

Age-based recommendations for cervical cancer screening

* USPSTF=United States Preventive Services Task Force; ACS=American Cancer Society; ASCCP=American Society for Colposcopy and Cervical Pathology; ASCP=American Society for Clinical Pathology; ACOG=American College of Obstetricians and Gynecologists.

The ACOG recommendations do not specify a particular type of Pap test. Both imaged and non-imaged Pap tests are acceptable under the recommendations. Non-imaged Pap tests, as well as the additional testing recommended by ACOG, are available at Quest Diagnostics and may be ordered individually. Quest Diagnostics offers menus with both imaged and non-imaged tests. Go to to find our menu of tests.

Defined as 3 consecutive negative Paps or 2 consecutive negative co-tests within the past 10 years, with the most recent test occurring within the past 5 years.

Dividing line

Co-testing vs Reflex testing: What's the difference?

Co-testing is not the same as Reflex testing. With co-testing, which is recommended for women ages 30 to 651-3, Pap and HPV testing are ordered together on the same accession. Reflex testing is a sequential approach, with an HPV test triggered by an ASC-US Pap.

Co-testing and Reflex testing chart


1. Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012; 62(3):147-172.

2. US Preventive Services Task Force. Final Update Summary: Cervical Cancer Screening. Accessed August 5, 2015.

3. The American College of Obstetricians and Gynecologists. Practice bulletin 131: Screening for cervical cancer. Obstet Gynecol. 2012;120(5):1222-1238.